From its inception in 1989 Stark (the Act), officially known as the Federal Physician Self-referral Law, has allowed an "ethical background" from which healthcare organization can build and maintain their own ethical regulations and protocols. In many ways, the Act has improved the quality of care available much in the way that antitrust laws have improved quality in the private business sector through the creation of competition. However, the Act is not without its own faults. For example, the Act basically covers Medicare issues in reference to financial relationships between physicians - their immediate family members - and the facilities which they refer Medicare patients (Gosfield, 2009).
This seems simple enough to understand, but many consider the Act to be outdated, very difficult to interpret, and follow (Sutton, 2011). Though the Act is written in very narrow and defined terms, difficulty is created due to its constant evolution and change. For this reason, many organizations have continued to create and apply their own version of the Act within their own organization. This has resulted in a general across the board "bench line" for each of employee of not accepting any freebies or kickbacks whatsoever from any vendor while under the employment of said employer. Sometimes even writing about the Act can be a bit of a mind twister!
This confusion has also led many to believe that the Act is also detrimental in many ways to the business of healthcare. As previously cited, the fear of violating the Act and as a result losing funding through Medicare and other government sources has created a tremendous fear amongst facilities. This, in turn, has created a very regimented business atmosphere that has significantly hurts a healthcare facility's ability to grow (Taylor, 1999).
Though the healthcare industry is not a business in the same sense as companies like Apple or Nike, it is still critical to remain as financially stable as possible. The Act like many other government regulations imposed on the healthcare industry has created a virtual mine field that organizations and administrators must navigate on a constant basis. Ethically, the Act has created a culture that strives to continually evolve ethically, but it should not stand in the way of creation, evolution, and ingenuity. If so, the healthcare industry at best will not perform to its abilities or at worst continually regress.
References:
Gosfield, A. (2009). Stark Law Covers a Narrow Corridor of Actions (Malpractice Consult). Medical Economics, 86(17), 38.
Sutton, P. (2011). The Stark Law in Retrospect. Annals of Health Law/Loyola University Chicago, School of Law, Institute for Health Law, 20(1), 15.
Taylor, M. (1999). Healthcare Struggles with Stark Reality. Modern Healthcare, 29(27), 30.
Wednesday, June 15, 2011
Monday, June 6, 2011
Ethical Tools for All
What exactly is the Healthcare Industry? Who works in the healthcare industry? Does it only constitute doctors, nurses, allied healthcare staff, hospitals, clinics, and the first aid station? For many, the healthcare industry is composed of the staff and facilities that provide direct patient care. However, those who support the healthcare industry have begun to be included, in the author's opinion, in this most important of all social clubs. For example, the individual billing clerk may not provide direct patient care, but their ability to properly (and ethically) code and bill insurance companies can have massive influence when compounded. Multiply their actions by as many billing clerks currently employed today, it is easy to see how billions of dollars and as an effect the quality of healthcare delivery can be seriously augmented by support staff.
While significant cost concerns support staff can create or alleviate is of vital importance to any healthcare facility, what can be said about the human cost? To an extent, support staff can create an environment conducive to increasing the quality of healthcare delivery while maintaining costs. Though nurses are very much considered an integral part of the "staff" of any hospital or related facility, they were considered for many years "support staff" to the all-mighty physician. As a result, more and more studies where conducted to see what affect, if any, nurses had on the health of the patient and finances. The result was not only the elevation of nurses to the level of physicians, but also the need for specialized nurses (Czaplinski, 1998).
With the obvious need for highly trained support staff continues to increase, have we done enough to also give these individuals the tools to act as professionals? Though the level of education is not indicative of one's level of professionalism, it is easy to assume that similar individuals may simply not understand or posses the knowledge to understand the intricacies of what makes a healthcare professional. More specifically, the need to understand and follow the highest ethical standards. Though high ethical standards within traditional healthcare facilities (like hospitals) have become the norm for all staff, many "support staff" operating in non-traditional facilities do not received the same amount (if any) of ethical training required of healthcare professionals. Though we expect support staff to function at the level of any healthcare professional, why do we not provide them with the same tools and expectations?
References:
Czaplinski, C. , et al. (1998). The Effect of Staff Nursing on Length of Stay and Mortality. Medical Care. V36:12. pp. 1626-1638.
While significant cost concerns support staff can create or alleviate is of vital importance to any healthcare facility, what can be said about the human cost? To an extent, support staff can create an environment conducive to increasing the quality of healthcare delivery while maintaining costs. Though nurses are very much considered an integral part of the "staff" of any hospital or related facility, they were considered for many years "support staff" to the all-mighty physician. As a result, more and more studies where conducted to see what affect, if any, nurses had on the health of the patient and finances. The result was not only the elevation of nurses to the level of physicians, but also the need for specialized nurses (Czaplinski, 1998).
With the obvious need for highly trained support staff continues to increase, have we done enough to also give these individuals the tools to act as professionals? Though the level of education is not indicative of one's level of professionalism, it is easy to assume that similar individuals may simply not understand or posses the knowledge to understand the intricacies of what makes a healthcare professional. More specifically, the need to understand and follow the highest ethical standards. Though high ethical standards within traditional healthcare facilities (like hospitals) have become the norm for all staff, many "support staff" operating in non-traditional facilities do not received the same amount (if any) of ethical training required of healthcare professionals. Though we expect support staff to function at the level of any healthcare professional, why do we not provide them with the same tools and expectations?
References:
Czaplinski, C. , et al. (1998). The Effect of Staff Nursing on Length of Stay and Mortality. Medical Care. V36:12. pp. 1626-1638.
Sunday, May 29, 2011
Doing what is right at the RIGHT time
As a future healthcare executive I often think about what is most important when running a healthcare organization. Obviously, it would be to my benefit to provide the highest quality services and access while maintaining a spotless reputation within my respective community. Many believe that maintaining a spotless reputation naturally entails making absolutely no medical errors. This is simply not the case. I have to vehemently disagree with this notion for a variety of reasons. No matter how high the caliber of your staff or how clean or up to date your facilities and equipment are there will always be medical errors. Healthcare executives must acknowledge that they and their staff are imperfect in nature. We should not and cannot expect anyone not to make mistakes. However, we also cannot allow for the trust we have created with our respective communities to be diminished.
Trust between a healthcare organization and the community is paramount. In many ways it is the "Alamo" of all requirements that constitute a quality healthcare organization. In other words, we as healthcare executives must guard this trust with all the power and tools that we have at our disposal. This requires that healthcare executives and healthcare organizations remain as transparent as possible in reference to its shareholders and the community in general. As painful as it may be, this also means that sharing information such as medical errors must be as thorough and as open as possible. For us to maintain our trust we must understand that "human relationships depend on communication of information; without an honest sharing of information there can be no trust. (Perry, 2002)"
Though healthcare executives are willing to share information of medical error with the community (they have to by law), I often wonder if they share this information quickly or thoroughly enough with those in the community. I recently ran across an article that details how a staff member at Emory University Hospital exposed almost 800 individual staff and patients to the potentially life threatening bacterial infection tuberculosis, known as TB (Moisse, 2011). The article briefly details how the community and those affected were made aware and then went on to describe TB. This information is important, but when did these infections occur? Did the executives in charge not only do the right thing, but did they do it at the right time? Generally, TB is very rare and can be completely eradicated if treated early enough. However, how are we to know if the people exposed were treated in an efficient and effective manner so as to avoid any permanent damage?
The healthcare industry continues to make significant strides in preventing medical error. This strides directly affect how organizations ethically treat situations when medical errors to arise. Though we have done a good job of preventing errors and following ethical guidelines we still need to create a culture that accepts the fact that medical errors will continue. We should embrace these situations as an opportunity to display that while we will make mistakes, our communities can always have trust that we will always do the right thing at the right time.
References:
1. F. Perry. (2002). Medical Errors: Paradise Hills Medical Center. The Tracks We Leave: Ethics in Healthcare Management. p. 1-15.
2. K. Moisse. (May 27, 2011). Atlanta Hospital Employee Exposed Hundreds to Tuberculosis. Retrieved May 29, 2011 from: abcnews.go.com/Health/Wellness/atlanta-hospital-notifies-700-patients-tuberculosis-exposure/story?id=13702727
Trust between a healthcare organization and the community is paramount. In many ways it is the "Alamo" of all requirements that constitute a quality healthcare organization. In other words, we as healthcare executives must guard this trust with all the power and tools that we have at our disposal. This requires that healthcare executives and healthcare organizations remain as transparent as possible in reference to its shareholders and the community in general. As painful as it may be, this also means that sharing information such as medical errors must be as thorough and as open as possible. For us to maintain our trust we must understand that "human relationships depend on communication of information; without an honest sharing of information there can be no trust. (Perry, 2002)"
Though healthcare executives are willing to share information of medical error with the community (they have to by law), I often wonder if they share this information quickly or thoroughly enough with those in the community. I recently ran across an article that details how a staff member at Emory University Hospital exposed almost 800 individual staff and patients to the potentially life threatening bacterial infection tuberculosis, known as TB (Moisse, 2011). The article briefly details how the community and those affected were made aware and then went on to describe TB. This information is important, but when did these infections occur? Did the executives in charge not only do the right thing, but did they do it at the right time? Generally, TB is very rare and can be completely eradicated if treated early enough. However, how are we to know if the people exposed were treated in an efficient and effective manner so as to avoid any permanent damage?
The healthcare industry continues to make significant strides in preventing medical error. This strides directly affect how organizations ethically treat situations when medical errors to arise. Though we have done a good job of preventing errors and following ethical guidelines we still need to create a culture that accepts the fact that medical errors will continue. We should embrace these situations as an opportunity to display that while we will make mistakes, our communities can always have trust that we will always do the right thing at the right time.
References:
1. F. Perry. (2002). Medical Errors: Paradise Hills Medical Center. The Tracks We Leave: Ethics in Healthcare Management. p. 1-15.
2. K. Moisse. (May 27, 2011). Atlanta Hospital Employee Exposed Hundreds to Tuberculosis. Retrieved May 29, 2011 from: abcnews.go.com/Health/Wellness/atlanta-hospital-notifies-700-patients-tuberculosis-exposure/story?id=13702727
Monday, May 23, 2011
Healthcare on Your Iphone
The marriage of technology and health care has been one of wedded bliss for some time now. It is hard to imagine a more perfect union that exists at any point throughout the ages. Often, the results are significant and important milestones in the continuous drive to improve the quality of life for all individuals. However, sometimes this marriage can create moral and ethical gray areas, even if the original intentions where noble .
As society continues to its technology march, I often stop to think of the advances we have made throughout my life. I can still remember the day when my 8th grade teacher explained how one day we will have computers small enough to carry in our hands and more powerful than the one we were currently using. This was less then 15 years ago and the arrival of the iPhone (along with other similar smart phones) continues to amaze me to this day. As a result, many technologies continue to be designed among the lines of smaller, cheaper, and more mobile. It isn't much of a surprise that the technology used in health care today follows those same guidelines. One example is the Vscan portable ultrasound device. This small device that resembles a mobile phone both in size and shape has the capability of recording and viewing the same images captured on traditional ultrasound machines with the added mobility of file sharing and email.
It's incredible to imagine the ability such a device has. For example, this breakthrough in technology allows physicians to visit patients in any setting without having to visit the doctors office. Such technology will allow physicians to visit patients in rural areas that do not have access to such technology. It's no wonder that such innovation not only improves the quality of life, but also greatly reduces the cost as the Vscan only costs roughly $8,000. These positives are very significant and important as we continue to struggle with providing quality health care to all individuals no matter their location or income level. However, what happens to all this information once it is gathered?
Though technology such as this has the ability to provide a quality service at low cost, do the companies that create such technologies invest time and effort into creating some kind of protocol to protect such sensitive information? What happens if the Vscan is lost or stolen? Is it possible that an individual could obtain sensitive information simply by just turning on the device? As an individual I fully embrace and welcome any form of technology that can improve the quality and access of health care, but as a future health care administrator I have to be cautious as to what information and who may use sensitive information against my clients. In the end we all have to acknowledge that even the best marriages have their problems.
References:
Simon, S. (2011, March 28). Medicine on the Move: Mobile Devices Help Improve Treatment. The Wall Street Journal. Retrieved from: online.wsj.com/article/SB10001424052748703559604576174842490398186.html
As society continues to its technology march, I often stop to think of the advances we have made throughout my life. I can still remember the day when my 8th grade teacher explained how one day we will have computers small enough to carry in our hands and more powerful than the one we were currently using. This was less then 15 years ago and the arrival of the iPhone (along with other similar smart phones) continues to amaze me to this day. As a result, many technologies continue to be designed among the lines of smaller, cheaper, and more mobile. It isn't much of a surprise that the technology used in health care today follows those same guidelines. One example is the Vscan portable ultrasound device. This small device that resembles a mobile phone both in size and shape has the capability of recording and viewing the same images captured on traditional ultrasound machines with the added mobility of file sharing and email.
It's incredible to imagine the ability such a device has. For example, this breakthrough in technology allows physicians to visit patients in any setting without having to visit the doctors office. Such technology will allow physicians to visit patients in rural areas that do not have access to such technology. It's no wonder that such innovation not only improves the quality of life, but also greatly reduces the cost as the Vscan only costs roughly $8,000. These positives are very significant and important as we continue to struggle with providing quality health care to all individuals no matter their location or income level. However, what happens to all this information once it is gathered?
Though technology such as this has the ability to provide a quality service at low cost, do the companies that create such technologies invest time and effort into creating some kind of protocol to protect such sensitive information? What happens if the Vscan is lost or stolen? Is it possible that an individual could obtain sensitive information simply by just turning on the device? As an individual I fully embrace and welcome any form of technology that can improve the quality and access of health care, but as a future health care administrator I have to be cautious as to what information and who may use sensitive information against my clients. In the end we all have to acknowledge that even the best marriages have their problems.
References:
Simon, S. (2011, March 28). Medicine on the Move: Mobile Devices Help Improve Treatment. The Wall Street Journal. Retrieved from: online.wsj.com/article/SB10001424052748703559604576174842490398186.html
Monday, November 29, 2010
Work Harder....please.
One of the most important goals for any manager is the ability to run their organization as efficiently and as effectively as possible. This means that all aspects of the organization need to operate in a manner that allows for the best outcomes to occur the first time, every time. For this to occur, it is critical for the manager to have a devoted, effective, and efficient workforce consisting of individuals who are properly trained and (most importantly) are happy with their job.
So, if we assume that efficiency and effectiveness is a byproduct of happiness, how can a manager at minimum ensure the happiness of their workforce? Often, compensation is considered amongst the most important aspects of worker happiness. However, it has been noted that compensation is not the most important determinant of worker happiness (Williams et al, 2007), it is actually one of many different units that determine worker happiness. Instead, to ensure the happiness of their workforce, manager should focus on a total benefits package (Balkin et al, 1993) that focuses on increasing the quality of life of the worker.
This understanding between the difference in compensation and quality of life is very difficult and almost impossible to compare. How do we measure a quantitative value (compensation) vs. a qualitative value (ie: quality of life) in the first place? Many human resources departments have taken it upon themselves to lean in one direction or another, often putting on emphasis on compensation or an emphasis on benefits. In many ways this is a positive for some workers, but is a negative for others. The reality is that benefits should not be viewed as a one size fits all. Rather, they should have the ability to change and be flexible enough to fit the needs and expectations of each individual worker. This is especially true at a time when private industry values flexibility, efficiency, and effectiveness above all aspects; why can't a benefits plan also mirror this belief?
Many benefits plan continue to offer outstanding pay scales, paid vacation, even wellness benefits all aimed at keeping the workforce content, thus leading to less turnover and greater worker efficiency/effectiveness. Though it is commendable that so many companies continue to strive to offer prospective employees a competitive benefits package that is both marketable and equitable, many still do not understand that "throwing money" at the problem will not cause it to go away. Instead, part of the recruitment process should be to gain further understanding of the individual to see what benefits actually are needed to fit their own life. This may help the organization to save money and provide evidence that it is willing and capable of adjusting to fit the needs of the individual. Such savings can even be passed on to the individual worker in the form of increased compensation (if provided they desire this) or even an increase in other benefits.
For an organization to survive and thrive will require further flexibility and adaption on the part of their benefits package. This ability to provide a better benefits package designed for the individual worker provides evidence that the organization is doing everything within its power to support the individual with their won goals and aspirations. This in turn can lead to greater worker happiness and result in a more efficient/effective workforce.
References:
1.)M.L. Williams, et al. 2007. Understanding Multiple Dimensions of Compensation Satisfaction. The Journal of Business and Psychology. V21:3, pp.429-459.
2.)D. B. Balkin, et al. 1993. The Determinants of Employee Benefits Satisfaction. The Journal of Business and Psychology. V7:3, pp. 323-339.
So, if we assume that efficiency and effectiveness is a byproduct of happiness, how can a manager at minimum ensure the happiness of their workforce? Often, compensation is considered amongst the most important aspects of worker happiness. However, it has been noted that compensation is not the most important determinant of worker happiness (Williams et al, 2007), it is actually one of many different units that determine worker happiness. Instead, to ensure the happiness of their workforce, manager should focus on a total benefits package (Balkin et al, 1993) that focuses on increasing the quality of life of the worker.
This understanding between the difference in compensation and quality of life is very difficult and almost impossible to compare. How do we measure a quantitative value (compensation) vs. a qualitative value (ie: quality of life) in the first place? Many human resources departments have taken it upon themselves to lean in one direction or another, often putting on emphasis on compensation or an emphasis on benefits. In many ways this is a positive for some workers, but is a negative for others. The reality is that benefits should not be viewed as a one size fits all. Rather, they should have the ability to change and be flexible enough to fit the needs and expectations of each individual worker. This is especially true at a time when private industry values flexibility, efficiency, and effectiveness above all aspects; why can't a benefits plan also mirror this belief?
Many benefits plan continue to offer outstanding pay scales, paid vacation, even wellness benefits all aimed at keeping the workforce content, thus leading to less turnover and greater worker efficiency/effectiveness. Though it is commendable that so many companies continue to strive to offer prospective employees a competitive benefits package that is both marketable and equitable, many still do not understand that "throwing money" at the problem will not cause it to go away. Instead, part of the recruitment process should be to gain further understanding of the individual to see what benefits actually are needed to fit their own life. This may help the organization to save money and provide evidence that it is willing and capable of adjusting to fit the needs of the individual. Such savings can even be passed on to the individual worker in the form of increased compensation (if provided they desire this) or even an increase in other benefits.
For an organization to survive and thrive will require further flexibility and adaption on the part of their benefits package. This ability to provide a better benefits package designed for the individual worker provides evidence that the organization is doing everything within its power to support the individual with their won goals and aspirations. This in turn can lead to greater worker happiness and result in a more efficient/effective workforce.
References:
1.)M.L. Williams, et al. 2007. Understanding Multiple Dimensions of Compensation Satisfaction. The Journal of Business and Psychology. V21:3, pp.429-459.
2.)D. B. Balkin, et al. 1993. The Determinants of Employee Benefits Satisfaction. The Journal of Business and Psychology. V7:3, pp. 323-339.
Wednesday, October 20, 2010
Can I Work for Free?
Now more then ever and internship has become one of the, if not the most important step any undergraduate or graduate student can take. Though many graduate students naturally work hard and do well in school, an internship can provide you with real world experience, networking opportunities, and exposure to important individuals. However, it also seems that now more then ever it is nearly impossible to work for free. This seems like a difficult issue to understand, but when you examine it more closely it (unfortunately) makes a great deal of sense.
The first hurdle an intern has to overcome is the stereotype of being unreliable and immature. Considering that many internships pay very little (or not at all) it would not be unusual for an intern to simply quit without giving any sort of prior notice. This is especially true if this same intern is lucky enough to be hired at another position within a full time capacity. To put it mildly, they would be fools not to leave this position as quickly as possible. However, how did this intern have the ability to be hired in the first place? Simple, they gained experience from their internship. This logic will eventually lead any Human Resource personnel to believe that in an intern-employer relationship the intern has everything to gain and the employer everything to lose.
The second hurdle an intern has to overcome is the reluctance of many employers to hire interns without pay in the first place. This practice is technically illegal because under federal law an employer cannot compensate an individual who is producing anything for them. In some circles this is considered almost a form of professional slavery. This means that, for example, a railroad intern can drive the engine all over as long as it's not pulling anything. This means that an intern cannot help pitch a new idea to a potential client or look for ways to save money within the budget. In many ways this law simply creates a more competitive atmosphere for interns. Now that they are paid employees (albeit not well paid) of an organization, it is considered that interns will produce for a company rather then learn from it. This in some ways is beneficial to both the intern and the employer, but can also be a very negative experience for the intern and employer. This is particularly troublesome considering that an intern is supposed to "learn" not "do" while they intern. To make this problem even worse, many employers have completely frozen or terminated any internships program to save money and avoid prosecution.
It seem ridiculous that a company would not want to hire (even at minimum wage) an individual who is obviously well qualified and willing to work hard for some exposure. Particularly in this current economic environment its hard to imagine why so many employers are not looking for new ideas to propel their organizations into the future. However, even with all these hurdles internships are still available and some can have very beneficial outcomes for both the intern and the employer. For example, many schools offer internships through their own relationships with business and community partnerships. More and more employers have begun to provide interns with "intern contracts" that morally and ethically "bind" the intern from any behavior that may be disruptive to the organization. Though such documents are not legal, it is highly frowned upon by professionals to go against your own word. There are also small businesses and start ups that are willing to gamble on the inexperience of a student for the possibility of finding the newest, freshest ideas within their respective industry. Though it may not be impossible to find an internship, it is incredibly hard to work for free.
The first hurdle an intern has to overcome is the stereotype of being unreliable and immature. Considering that many internships pay very little (or not at all) it would not be unusual for an intern to simply quit without giving any sort of prior notice. This is especially true if this same intern is lucky enough to be hired at another position within a full time capacity. To put it mildly, they would be fools not to leave this position as quickly as possible. However, how did this intern have the ability to be hired in the first place? Simple, they gained experience from their internship. This logic will eventually lead any Human Resource personnel to believe that in an intern-employer relationship the intern has everything to gain and the employer everything to lose.
The second hurdle an intern has to overcome is the reluctance of many employers to hire interns without pay in the first place. This practice is technically illegal because under federal law an employer cannot compensate an individual who is producing anything for them. In some circles this is considered almost a form of professional slavery. This means that, for example, a railroad intern can drive the engine all over as long as it's not pulling anything. This means that an intern cannot help pitch a new idea to a potential client or look for ways to save money within the budget. In many ways this law simply creates a more competitive atmosphere for interns. Now that they are paid employees (albeit not well paid) of an organization, it is considered that interns will produce for a company rather then learn from it. This in some ways is beneficial to both the intern and the employer, but can also be a very negative experience for the intern and employer. This is particularly troublesome considering that an intern is supposed to "learn" not "do" while they intern. To make this problem even worse, many employers have completely frozen or terminated any internships program to save money and avoid prosecution.
It seem ridiculous that a company would not want to hire (even at minimum wage) an individual who is obviously well qualified and willing to work hard for some exposure. Particularly in this current economic environment its hard to imagine why so many employers are not looking for new ideas to propel their organizations into the future. However, even with all these hurdles internships are still available and some can have very beneficial outcomes for both the intern and the employer. For example, many schools offer internships through their own relationships with business and community partnerships. More and more employers have begun to provide interns with "intern contracts" that morally and ethically "bind" the intern from any behavior that may be disruptive to the organization. Though such documents are not legal, it is highly frowned upon by professionals to go against your own word. There are also small businesses and start ups that are willing to gamble on the inexperience of a student for the possibility of finding the newest, freshest ideas within their respective industry. Though it may not be impossible to find an internship, it is incredibly hard to work for free.
Sunday, September 26, 2010
Outsourcing Patient Care
As the recession continues to drive businesses to adapt and innovate, many organizations have found it much more cost effective to outsource what were once considered "in-house only" services. These sentiments are also being felt throughout the healthcare industry as new healthcare reform laws begin to take affect. However, while the current recession plays a significant role in the outsourcing of individual positions within the healthcare industry the main reason for this rise in outsourcing is not financial, rather it has to do with the availability of qualified professionals to fill these roles. Even more interesting is that the majority of these outsourced jobs pay as much (even more) then a typical U.S. based position. These factors combined with the ability of foreign professionals to be trained, educated, and licensed in the U.S., it isn't a mystery why so many positions are being filled by others outside of the U.S.
Take for example an Altoona, PA hospital. Only a few years ago, the number of nigh time cases in need of interpretation by a radiologist got so bad, the seven on staff members had to consistently work 60+ hours per week just to cover all the work. All this changed when the hospital began to outsource their work to a small Bangalore, India firm called Teleradiology Solutions. This firm is operated and owned by Dr. Arjun Kalyanpur, who happens to be educated at Yale University and licensed in the U.S.
It's extremely perplexing to find an industry that is not outsourcing due mainly for financial reasons, but rather mainly due to a severe shortage of professionals within its own borders. How did this "telemedicine" trend begin? Many researchers point to the sharply rising demand for IT professionals to tackle the Y2K "bug" of the late 1990's. This demand led to many foreign students (particularly from India) to migrate to the U.S. for education and training. This trend became such the norm, that US officials often joked that "President Bush had sacked the elected members of Congress and was replacing them with staff hired in Bangalore" (Chithelen, 2004).
So what is an HR department to do? On one hand you have very qualified, American trained/educated/licensed and English speaking professionals ready and capable of working when everyone else is sleeping. On the other hand, you still need to pay them just as much (considering the need, possibly even more), you need to educate yourself with foreign laws, and deal with the possibility of high turnover (over 50% in service sector jobs outsourced to India). These problems coupled with recession, and the incredible need from Americans to find skilled, well paying positions it can only give you a glimpse of the massive problem this recession has created.
While the rest of the world was willing to work hard, sacrifice, and become better trained, American workers simply lacked the understanding to make more savvy career moves and HR administrators could not for see the future needs of the industry. However, even with this problem the reality is that the need is still needed. This need creates the oppurtunity for the American worker to receive the same kind of training and (considering their relative vicinity)more then likely receive preferential treatment when filling these positions. Even in the midst of the "Great Recession" there is still oppurtunity and hope left; all that HR administrators can do is hope that others see this as well.
References:
1.) Outsourcing to India: Causes, Reactions, and Prospects. Chithelen, Ignatius. Economic and Political Weekly. 39:10 (2004), pp. 1022-1024.
Source:
Some U.S. Hospitals Outsourcing Work: Shortage of Radiologists spur Growing Telemedicine Trend. msnbc.msn.com/id/6621014
Take for example an Altoona, PA hospital. Only a few years ago, the number of nigh time cases in need of interpretation by a radiologist got so bad, the seven on staff members had to consistently work 60+ hours per week just to cover all the work. All this changed when the hospital began to outsource their work to a small Bangalore, India firm called Teleradiology Solutions. This firm is operated and owned by Dr. Arjun Kalyanpur, who happens to be educated at Yale University and licensed in the U.S.
It's extremely perplexing to find an industry that is not outsourcing due mainly for financial reasons, but rather mainly due to a severe shortage of professionals within its own borders. How did this "telemedicine" trend begin? Many researchers point to the sharply rising demand for IT professionals to tackle the Y2K "bug" of the late 1990's. This demand led to many foreign students (particularly from India) to migrate to the U.S. for education and training. This trend became such the norm, that US officials often joked that "President Bush had sacked the elected members of Congress and was replacing them with staff hired in Bangalore" (Chithelen, 2004).
So what is an HR department to do? On one hand you have very qualified, American trained/educated/licensed and English speaking professionals ready and capable of working when everyone else is sleeping. On the other hand, you still need to pay them just as much (considering the need, possibly even more), you need to educate yourself with foreign laws, and deal with the possibility of high turnover (over 50% in service sector jobs outsourced to India). These problems coupled with recession, and the incredible need from Americans to find skilled, well paying positions it can only give you a glimpse of the massive problem this recession has created.
While the rest of the world was willing to work hard, sacrifice, and become better trained, American workers simply lacked the understanding to make more savvy career moves and HR administrators could not for see the future needs of the industry. However, even with this problem the reality is that the need is still needed. This need creates the oppurtunity for the American worker to receive the same kind of training and (considering their relative vicinity)more then likely receive preferential treatment when filling these positions. Even in the midst of the "Great Recession" there is still oppurtunity and hope left; all that HR administrators can do is hope that others see this as well.
References:
1.) Outsourcing to India: Causes, Reactions, and Prospects. Chithelen, Ignatius. Economic and Political Weekly. 39:10 (2004), pp. 1022-1024.
Source:
Some U.S. Hospitals Outsourcing Work: Shortage of Radiologists spur Growing Telemedicine Trend. msnbc.msn.com/id/6621014
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